Individual
JACOB ANTHONY OLWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3001 EDWARDS MILL RD, RALEIGH, NC 27612-5243
(919) 781-4060
Mailing address
3001 EDWARDS MILL RD STE 200, RALEIGH, NC 27612-5243
(919) 781-4060
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2306606052
VA
225200000X
Physical Therapy Assistant
Primary
7264
NC
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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